AI Article Synopsis
- This study examined the link between perineural invasion (PNI) and biochemical recurrence (BCR) in prostate cancer patients after open radical prostatectomy (ORP).
- A total of 1,040 patients were analyzed, revealing that those with PNI had significantly shorter BCR-free survival compared to those without it, even after adjusting for other factors like PSA levels and Gleason scores.
- The findings highlight PNI as a key predictor of BCR, indicating a higher risk for patients with this condition, despite some limitations in the study's design.
Article Abstract
Purpose: To explore the association between perineural invasion (PNI) and biochemical recurrence (BCR) in patients undergoing open radical prostatectomy (ORP).
Methods: A retrospective observational study was conducted, in which we analyzed patients who underwent ORP at our institution between 2003 and 2020. The biochemical recurrence (BCR)-free survival and overall survival (OS) rates were defined using the Kaplan-Meier method and log-rank analysis. Multivariable Cox-regression models were used to test the effect of other different factors such as preoperative PSA, Gleason score and T stage on biochemical recurrence. The Clavien-Dindo classification was used to report the complication rates.
Results: In total, 1040 patients were included. PNI was found in 458 (44.1%) and BCR occurred in 212 patients (20.4%) at a median follow-up of 91.2 months. After undergoing the procedure, 216 patients received adjuvant external beam radiotherapy (EBRT). Despite receiving adjuvant treatment, the BCR-free survival was still significantly shorter for PNI-positive patients (mean 32.2 vs. 62.3 months, p < 0.001). The 5- and 10-year BCR-free survival rates for patients without PNI were 90% and 81%, respectively. For the same period of time, BCR-free survival rates for patients with PNI were 75 and 63%, respectively. Therefore, PNI was a strong predictor of BCR (p < 0.001). These results remained even after controlling for established predictors of biochemical recurrence. Limitations include retrospective and single-center study design.
Conclusion: In conclusion, despite its limitations, our study emphasizes the prognostic importance of PNI in prostate cancer patients. The results demonstrate that the presence of PNI is associated with a high risk of BCR.
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| http://dx.doi.org/10.1007/s00345-022-04158-1 | DOI Listing |
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